Bupa’s response to Four Corners’ ‘Mind the Gap’

The main concern of our customers is the affordability of healthcare, and the impact of unexpected out-of-pocket costs.

The ABC’s Four Corners episode highlights exactly why Bupa members want transparency around medical fees.

The majority of doctors are doing the right thing financially by their patients, but the program has revealed the huge impact of those that aren’t.

Bupa’s Managing Director of Health Insurance Dr Dwayne Crombie says the report highlights the behaviour of a significant minority in the private system. 

“The only way things will change is if consumers put pressure on doctors. They can’t ignore that. People should refuse to patronise those who overcharge.”

Patients should know how much a doctor charges, before a procedure or medical appointment occurs.

These costs should be provided in writing, and in advance by the doctor. Patients should feel encouraged to ask the doctor to explain all costs.

Any out of pocket costs, such as doctors' fees or hospital fees, must be explained in advance.

This is a critical component of informed financial consent.

The out of pocket fees doctors charge for a procedure undermine the value private health insurance provides.

If customers are forced to pay out of pocket gaps because a fee is high, it’s not unreasonable for people to question what benefit insurance provides them, without realising where the cost is coming from and why they are having to pay it.

“Never be afraid to get a second opinion,” says Dr Crombie, “people shouldn’t be emotionally pressured when they are sick and vulnerable.“

As the program explained, private health insurance is legislated as to what it can cover and charges outside of this framework leave patients annoyed.

What can you do?

Check first.

Health insurers like Bupa list No Gap providers on their websites.

Don’t be afraid to talk money. It’s yours after all.

Speak to your doctor or specialist prior to any procedure. If you think a quoted out of pocket cost is too high, ask why.

If you’re not happy with the response to your questions, you can speak to other doctors, or call your health insurer.